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<br /> File Original with DWR State of California DWR U"Only-DoNot Fill In
<br /> Well Completion Report
<br /> Page 1 of 3 Refer to Instruction Pamphlet State Well Number/Ste Number
<br /> Owner's Well Number AMW-23 No. e0084071 �
<br /> N II I I I I I IWI
<br /> 0 to Work Began 11/18/2008 Date Work Ended 11/20/2008 Latitude Longitude
<br /> cal Permit Agency San Joaquin County
<br /> Permit Number SR#0055551 Permit Date 10/22/08 APN/TRS/Other
<br /> Geolo is Log
<br /> Well Owner
<br /> Orientation OVertical 0Horizontal OAngle Specify Name Forward Incorporated
<br /> Drilling Method Mud Rotary Drilling Fluid Mud
<br /> Depth from Surface Description Mailing Address 9999 S.Austin Road
<br /> Feet to Feet Describe material,grain size,color,etc City Manteca State CA Zi 95336
<br /> 0.0 75.0 Not Sampled Well Location
<br /> 75.0 75.9 Silty CLAY,rust bands,few micas and sands Address w/in 1500'West of Austin Road
<br /> 5 YR 5/6 City Stockton County San Joaquin
<br /> 75.9 76.5 Clayey SILT, barite lenses, micas present,dry, Latitude 37 53 39.30 N Longitude -121 11 21.58w
<br /> very stiff 10 YR 6/6 Dec. Min. Sec. Dec. Min. Sec.
<br /> 76.5 80.0 Clayey SILT Datum WGS84 Decimal Lat. 37.894 Decimal Long. -121.189
<br /> 80.0 81.4 Clayey SILT,with some fine sands APN Booklal Page 150 Parcel 11
<br /> 81.4 85.0 Clayey SILT Township 1 North Ran e.7 East Section 34
<br /> 85.0 85.8 Silty SAND,stiff, moist,micas,fine grained, _ " Location Sketch Activity,
<br /> 5 YR 4/4 Sketch must tie drawn"b Shand afEerform isprint Qi New Well
<br /> North 0 Modification/Repair
<br /> 85.8 86.4 Silty SAND,moist,fine grained, med.stiff 0 Deepen
<br /> 5 YR 4/4 O Other
<br /> 86.4 90.0 Silty SAND 0 Desunder"trGEoy
<br /> LOG"
<br /> proceduOLOGICres and materials
<br /> 90.0 91.5 Sitly CLAY, hard,dry, rust banding,and barite
<br /> banding 10 YR 5/4 ,Planned linea
<br /> 91.5 95.0 Silty CLAY 0 Water Supply
<br /> 95.0 95.2 CLAY,soft, moist, med.grained sands peppered [:]Domestic ❑Public
<br /> in,5 YR 4/1 w ❑Irrigation ❑Industrial
<br /> 95.2 96.1 Sandy CLAY,dry, hard, med.grained sands-fine O Cathodic Protection
<br /> O Dewatering
<br /> gravels throughout 10 YR 4/4 O Heat Exchange
<br /> 96.1 100.0 Sandy CLAY O Injection
<br /> 100.0 100.9 Silty SAND,fine grained,hard, rust staining, O Monitoring
<br /> 5 YR 4/4 O Remediation
<br /> 100.9 101.0 Sandy SILT,fine grains,dry,very stiff, 10 YR 4/2 O Sparging
<br /> 101.00 105.0 Sandy SILT South O Test Well
<br /> Illustrate or describe distance of well from roads,buildings,fences. O Vapor Extraction
<br /> er
<br /> 105.0 106.3 CLAY, hard,dry,abundant micas,rust staining s,etc and attach a map.Use additional paper if necessary O Other
<br /> 5 YR 5/4 Please be accurate and complete
<br /> 106.3 110.0 CLAY Water Level and Yield of CornipjetdO Well`a
<br /> 110.0 110.2 CLAY;:but soft Depth to first water N/A (Feet below surface)
<br /> Depth to Static
<br /> Water Level 69.77 (Feet) Date Measured 12/08/2008
<br /> Total Depth of Boring 185 Feet***See Note Estimated Yield* N/A (GPM) Test Type N/A
<br /> Total Depth of Completed Well 185 Feet at Bottom Test Length N/A (Hours) Total Drawdown N/A (Feet)
<br /> *May not be representative of a well's long term yield.
<br /> Casin"s Angular Material
<br /> Depth from Borehole Type Material Wall Outside Screen Slot Size Depth from
<br /> Surface Diameter YP Thickness Diameter Type if Any Surface Fill Description
<br /> Feet to Feet inches Inches Inches Inches Feet to Feet
<br /> 0 159 8 Blank PVC Sch.80 0.218 2.375 N/A N/A 0 1150 1 Concrete Quickrete Concrete
<br /> 159 184 8 Screen PVC Sch.80 0.218 2.375 PVC 0.010 150 154 Bentonite Pel-Plug Bentonite Pellets
<br /> 159 184 Sane 2112 Cemex Lapis Lustre Sand
<br /> Attachments ; Certificatiorr"Statement,
<br /> 7additional
<br /> gic Log I,the undersigned,certify that this report is complete and accurate to the best of my knowledge and belief
<br /> onstruction Diagram Name Dave Vasbinder Herst&Associates Inc.
<br /> n,Firm or Corporation
<br /> hysical Log(s) 4630 S. Hwv9NOuter Road Saint Charles MO 63304
<br /> ater Chemical Analyses Addres City State Zip
<br /> Signed 1 / _®ot 636387
<br /> Atnformation 'rf it exists. C-57 Licensed Water Well Contractor Date Si ned C-57 License Number
<br /> ***Drilling depth scale begins at one foot above ground surface due to required drilling rig setup
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